Since the introduction of Viagra — the first drug approved to treat erectile dysfunction — in 1998, the little blue pill has helped transform the sex lives and relationships of many of the 30 million American men with ED.
ED drugs (which now also include Levitra and Cialis) work by relaxing smooth muscle cells to improve the flow of blood into the penis. And for most men, they are safe and effective.
But ED drugs also come with a number of side effects — and for men with certain health conditions, they can be dangerous.
Should You Be Popping the Little Blue Pill?
Since ED drugs affect blood vessels in other areas of the body (and not just the penis), they can be dangerous when combined with other medications or if you have certain medical conditions.
You should think twice about taking ED drugs if:
- You take certain medications. Dangerous drops in blood pressure can occur in men who are taking nitroglycerin for chest pain or tamsulosin hydrochloride (Flomax) for an enlarged prostate, warns John S. Wheeler, MD, a urology professor at the Stritch School of Medicine at Loyola University in Chicago. Combine nitrate-based drugs like nitroglycerin with ED drugs, and you could have a dangerous mix. Other drugs called alpha-blockers, which are used to treat prostate enlargement or high blood pressure, may have a similar affect when combined with ED drugs.
- You’re at risk for heart attack or stroke. Because ED drugs can cause arteries to widen in the heart and the brain, as well as the penis, they could be especially dangerous if you have had a stroke, heart attack, or heart rhythm problem in the past six months.
- You have these health conditions. Caution is also urged for any man who has a history of congestive heart failure, unstable angina, low blood pressure, or uncontrolled high blood pressure.
Can you be too old for ED drugs? “There are no absolute age limits for ED drug use,” says Dr. Wheeler. “As long as a man is sexually active, could benefit from an ED drug, and is healthy enough for sex, these drugs can be prescribed.”
And what about women experiencing sexual dysfunction — should they take ED drugs? While studies show that ED drugs may improve blood flow to the vagina, which can increase vaginal secretions, these drugs are rarely used to treat female sexual dysfunction.
Common Erectile Dysfunction Drug Side Effects to Consider
No matter which ED drug your doctor prescribes, side effects may include:
- Muscle aches
- Visual changes
- Hearing loss
- Facial flushing
- Nasal congestion
- Long-lasting erection
Headaches are the most common side effect associated with ED medications. The sudden change in blood flow from the increased levels of nitric oxide causes the headaches.
This side effect is common with all forms of ED medications, so switching brands won’t necessarily alleviate your symptoms. If you have headaches from your ED drug, talk to your doctor about how to prevent them.
Body aches and pains
Some people have muscle aches and pains throughout their bodies while taking ED medications. Others have reported specific pain in their lower back. If you have these types of pain while taking ED medication, over-the-counter (OTC) pain medication may help.
However, you should talk to your doctor about other possible causes of your pain. Your doctor can help you choose an OTC medication that is safe to take with your ED medications and with any other medications you take.
Digestive system problems
Your ED medication may cause uncomfortable digestive system side effects. The most common are indigestion and diarrhea.
To help relieve minor problems, consider making dietary changes to reduce upset stomach. Drinking water instead of caffeinated beverages, alcohol, or juice may help. If changing your diet doesn’t work, talk to your doctor about OTC remedies that may help.
An increase in nitric oxide can cause some men to become dizzy. The dizziness caused by ED medications is generally mild. However, any dizziness can cause discomfort during everyday activities.
In rare cases, dizziness from ED medications has led to fainting, which can become a serious health issue. You should tell your doctor if you experience dizziness while taking ED medications. If you faint while taking these medications, see your doctor right away.
ED medications can change the way you see things — literally. They can temporarily alter your eyesight and even cause blurry vision. ED medications aren’t recommended if you have had vision loss, or a retinal disorder called retinitis pigmentosa.
A complete loss of vision or changes that don’t go away can signify a more serious issue with your ED medication. Seek emergency medical care if you experience these symptoms.
Flushes are temporary periods of redness of the skin. Flushes usually develop on your face and may also spread to parts of your body. Flushes can be mild, like blotchy skin, or severe, like rashes. Although the appearance may make you uncomfortable, flushes typically aren’t harmful.
Flushes from ED medications may get worse when you:
- eat hot or spicy foods
- drink alcohol
- are outside in warm temperatures
Congestion and runny nose
Congestion or a runny or stuffy nose can be a common symptom of ED medications. In most cases, these side effects go away without treatment. Talk to your doctor if they persist.
Recognizing uncommon, severe side effects
Minor side effects are common when taking ED medication. Still, there are a few side effects that aren’t as common, and some can even be dangerous. Severe side effects of ED medications can include:
- priapism (erections that last longer than 4 hours)
- sudden changes in hearing
- vision loss
Contact your doctor immediately if you have any of these severe side effects.
Certain men are more at risk of these side effects than others. This may be because of other conditions they have or other medications they take.
When discussing ED treatment with your doctor, it’s important to tell them about all drugs that you take and other health conditions you have. If ED drugs aren’t right for you, your doctor may suggest other treatment options, such as surgery or vacuum pumps.
If you are having any of these side effects, you should let your doctor know. Specially, if you have an erection that won’t go away, or any visual or hearing problems, let your doctor know immediately.
Other Ways to Treat Erectile Dysfunction
Doctors usually start with the simplest and safest treatments for erectile dysfunction — in fact, they may suggest lifestyle changes before trying medication.
Consider these other treatment options:
- Make lifestyle changes. Quitting smoking, cutting back on alcohol, getting regular exercise, and losing weight have all been shown to help with erectile dysfunction.
- Seek psychological help. In about 20 percent of ED cases, the source is psychological: Anxiety, depression, and relationship issues may all contribute to erectile dysfunction. Working with a mental health provider may help.
- Try injectable medications. If oral drugs do not work, other drugs may be injected or inserted into the penis (causing an erection within minutes). Although they have been shown to be very effective, they may come with a certain amount of discomfort.
- Use a vacuum pump. A pump can be placed over the penis and used to draw blood into the penis to cause an erection. An elastic ring at the base of the penis can be used to maintain the erection for up to 30 minutes.
- Consider surgery. Surgical procedures used to treat erectile dysfunction include implants and reconstruction of blood vessels in the penis. Surgery is usually the last resort — but it can be an effective solution for some.
Always discuss treating erectile dysfunction with your doctor before trying any ED drug — or other treatment — on your own.
There’s no proof that over-the-counter sexual enhancement supplements for men work, and some are potentially dangerous, a new study reports.
Many men seeking medical help for sexual health issues report using dietary supplements. But with little regulation of dosage or ingredients, the health effects of these products are unknown, the researchers said in background notes.
And many of these products contain traces of an ingredient used in drugs like Viagra that can be dangerous to men with certain health problems, the researchers added.
The researchers identified top-selling male sexual-help supplements and analyzed the ingredients, including those in products marketed to enhance erections, desire and sexual performance.
“While certain natural supplements we reviewed show promise for improving mild sexual dysfunction, they lack robust human evidence,” study senior author Dr. Ryan Terlecki, an associate professor of urology at Wake Forest Baptist Medical Center in Winston, Salem, N.C., said in a center news release.CONTINUE READING BELOW
“In addition, because of concerns that some products are impure or weak, we do not routinely recommend these products to our patients,” he added.
Some of the most commonly used products include horny goat weed, ginseng, DHEA, Ginkgo biloba, fenugreek and maca, the researchers found.
For many of the products, there’s no scientific evidence to support claims they can improve libido, erectile dysfunction or sexual performance, the researchers said.
They also found that some of the supposedly “natural” products have traces of phosphodiesterase-5-inhibitors (PDE5Is), the medication found in prescription drugs — such as Viagra — used to treat impotence.
One study reviewed by the researchers found that 81 percent of tested samples of over-the-counter male sexual enhancement products bought in the United States and Asia contained PDE5Is.
“PDE5Is cannot yet be legally sold over the counter in this country,” Terlecki said. “Men who use these medications without a physician’s supervision run the risk of taking them inappropriately. Patients with advanced heart disease, for example, or who take nitrates, such as nitroglycerin, should not use PDE5Is as it may cause an unsafe drop in blood pressure. Likewise, men with severe liver impairment or end-stage kidney disease requiring dialysis should avoid these products.”
Also, men who take medications such as Flomax (tamsulosin), terazosin or doxazosin to treat an enlarged prostate are at risk for dizziness and falls if they take PDE5Is at the same time, the researchers said.
The study was published recently in the Journal of Sexual Medicine.